Second transcatheter closure for residual shunt following percutaneous closure of patent foramen ovale

Susuri, Njomeza; Obeid, Slayman; M, Ulmi; Siontis, George C.M.; Wahl, Andreas; Windecker, Stephan; Nietlispach, Fabiàn; Meier, Bernhard; Praz, Fabien

doi:10.4244/eij-d-17-00061

Cited by 16 publications

(12 citation statements)

References 30 publications

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“…In patients treated with larger occluders (≥30 mm), residual shunt was more frequent at 6 months (53% vs. 11%, P < 0.001). As previously, described by our group, the use of a larger device (≥30 mm) predicted the occurrence of residual shunt at 6 months (OR 9.7; 95% CI 2.9–32.5) . A similar trend was apparent for patients with ASA (residual shunt 23% vs. 11% in those without ASA; P = 0.09).…”

Section: Resultssupporting

confidence: 83%

“…In six patients (4%) of this series, the procedure consisted of repeat PFO closure for treatment of residual shunting after implantation of a first occluder. The specific technical aspects of such procedures have been described in detail elsewhere …”

Section: Methodsmentioning

confidence: 99%

“…A contrast TEE including at least two Valsalva maneuvers was recommended after 6 months and performed either at our center or by the referring cardiologist to confirm complete closure. Patients with residual shunt ≥2 were offered a second procedure …”

Section: Methodsmentioning

confidence: 99%

“…The specific technical aspects of such procedures have been described in detail elsewhere. 21 Routine diagnostic coronary angiography was offered in the following situations: patients suspected of coronary artery disease (CAD) or with known CAD requiring surveillance of progression or patients with risk factors for CAD, at an age >40 years in men and >50 years in women. 22 If significant lesions were found, ad hoc PCI was performed except for patients requiring coronary artery bypass grafting.…”

Section: Percutaneous Pfo Closurementioning

confidence: 99%

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Percutaneous patent foramen ovale closure during live case demonstrations

Praz

Siontis

Xhigoli

et al. 2018

Cathet Cardio Intervent

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Background Live case demonstrations serve as an educational tool for interventional techniques in cardiology. The aim of this study was to assess the safety and technical success of percutaneous patent foramen ovale (PFO) closure during live case demonstrations. Methods All patients who had undergone percutaneous PFO closure with Amplatzer devices during live case demonstrations at our institution were consecutively included in this retrospective analysis. Procedure related events were compared with summary event rates derived from the eight randomized controlled trials (RCTs) investigating PFO closure, as well as with a propensity matched cohort of patients treated under usual conditions. Results From April 2004 to June 2015, 142 patients underwent percutaneous PFO closure during live demonstrations, mainly for secondary prevention of cryptogenic cerebrovascular events. The interventions were fluoroscopy guided and successful in all but three cases (2%). Minor adverse events occurred in nine patients (6%). Contrast TEE performed at about 6 months showed complete closure in 84%. No significant differences with regard to technical success and major complications rate were found compared to RCTs, except for an increased rate of minor bleeding observed during live case demonstrations (P for difference < 0.001), mainly attributable to concomitant arterial access for incidental coronary angiography performed in 70% of patients. Except for slightly longer procedure duration, no difference was found compared to a matched population treated under usual conditions. Conclusion Percutaneous PFO closure can be performed during live case demonstrations with the same high technical success as during routine cases.

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Section: Resultssupporting

confidence: 83%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Percutaneous Pfo Closurementioning

confidence: 99%

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Percutaneous patent foramen ovale closure during live case demonstrations

Praz

Siontis

Xhigoli

et al. 2018

Cathet Cardio Intervent

Self Cite

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“…Residual RLS Cardiac or extracardiac 6À11 Collado et al 2018Greutmann et al 2009Mojadidi et al 2014a, 2014bShah et al 2018Susuri et al 2017Wintzer-Wehekind et al 2019 would be appropriate during high-risk events causing transient bacteremia.…”

Section: Post-procedures Follow-upmentioning

confidence: 99%

Patent Foramen Ovale: Pivotal Role of Transesophageal Echocardiography in the Indications for Closure, Assessment of Varying Anatomies and Post-procedure Follow-up

Vitarelli

2019

Ultrasound in Medicine & Biology

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Patent foramen ovale (PFO) is present in 15%À30% of the general population and has been associated with various pathologic states, including cryptogenic stroke, platypneaÀorthodeoxia syndrome, decompression sickness and migraine with auras. Transesophageal echocardiography (TEE) has a major role in the diagnostic evaluation of PFO, as well as in the post-procedural assessment after transcatheter closure. The goals of this article were to synthesize the echocardiographic transesophageal techniques required for accurate PFO diagnosis and careful anatomic assessment of its anatomic variants, to focus TEE indications for device closure as complementary to clinical indications and to assess the role of TEE in the post-procedure follow-up.

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